It’s one of the hottest activities among the college-age crowd in Michigan.

It’s also a public health menace, according to area public health officials and consultants.

Local doctors, health officials and consultants chaired a panel at Royal Oak Beaumont Hospital on Tuesday afternoon to raise awareness of the negative health effects of hookah smoking and the issues communities face in addressing misconceptions about the practice.

Panelist Dr. Sam Fawaz is a co-founder and organizer of the Hookah Community Coalition, an organization intent on informing the public of the risks of hookah smoking — an activity Fawaz said has benefited from lack of awareness of its health effects.

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The CDC states that an hour-long session with a hookah can produce nearly 200 times (90,000 ml) the volume of smoke of a single cigarette (500-600 ml).

Fawaz said that while hookah is normally associated with Middle Eastern communities, it’s an activity that transcends any kind of societal boundaries.

“It’s from young to old, it’s from rich to poor, it’s black, brown and white and everything else in between,” Fawaz said. “And that’s what scares me about this tradition and social activity.”

Wali Altahif, a public health specialist who works with the Arab-American and Chaldean Council, said the biggest problem revolving around hookah usage in Michigan is the apparent lack of awareness that it is an 18-and-up activity.

“We have a law and the law is very clear,” he said. “It says that no one under the age of 18 shall use or smoke hookah. We see that all over the state; it’s a clear violation of the law.”

Education is important as well, Altahif said. The ACC put together and distributed an education hookah retail kit in order to clarify state laws so that new establishments don’t find themselves in violation.

But it’s difficult for places to remain in good standing with the law when they’re violating it in the first place just by existing.

They have to have a license to operate,” he said, noting that only 200 such licenses exist in the state of Michigan. “Ninety percent of these hookah places don’t have an exemption or license to operate.”

He added that other violations, including food and alcohol being served, act as an incentive to continue educating the public — but the effects of that education seem to be showing already.

Dr. Farid Shamo, a consultant with the Michigan Department of Community Health’s Tobacco Prevention and Control Division, said that surveys performed in 2005-2006 and 2009-2010 shows that there has been progress in the dissemination of factual information regarding hookah smoking.

The 2005-2006 survey showed that 65 percent of those surveyed smoked hookah, while in 2009-2010, that number fell to 34 percent. Around 75 percent of respondents in the earlier survey believed hookah was safer than cigarettes, while just 45 percent said the same in the later survey.

But that’s still a big chunk of smokers being exposed to unique potential ailments, according to Dr. Ghada Saad, a Dearborn-based dentist.

“It’s led to an increase in a lot of herpes cases we’ve been seeing,” she said. “A lot of oral sores. The herpes simplex virus is very contagious and when they sit around for hours and they’re sharing this thing, they’re transmitting bacteria from mouth to mouth which can lead to a number of things.”

Like infections, spread of flu and eventually even oral cancer and gum disease.

“It’s going to increase,” she said. “It’s just unhealthy in general for us to spread bacteria from one mouth to another.”

In concluding the panel, Fawaz said that while he is not anti-business, he intends for the group to continue educating the public to dispel any misconceptions about the supposed “safety” of hookah smoking.

“Everybody has a vice,” he said. “We’re all adults. People drink too much sometimes, people smoke cigarettes, but this issue in particular hits home for me because I see a lot of teenagers doing it under the impression that it’s not smoking or it’s not dangerous.”